The EVEREST II trial has shown the MitraClip has similar mortality rate to that of surgery and, on the other hand, we are well aware that residual mitral regurgitation (MR) is associated with a strong negative impact. However, research has shown little about transvalvular gradient after MitraClip and what it entails. 268 patients receiving MitraClip were…
New-Generation ACURATE Neo2
Transcatheter aortic valve replacement (TAVR) is a therapeutical option for patients with symptomatic severe aortic stenosis. Current guidelines recommend TAVR in patients ≥75 years with intermediate risk. One of the most frequent complications of this procedure is moderate or greater aortic regurgitation (AR) after implantation. Consequently, new valves have been developed to try and reduce…
MitraClip Reduces Renal Function Deterioration
Severe mitral regurgitation is associated to cardiac failure and hospitalization and over time is accompanied by kidney failure, which leads to higher mortality. In the COAPT study, in patients with low ejection fraction, MitraClip showed benefits over medical treatment, but there was an important group of people with kidney function deterioration. The evolution and benefit…
TAVR: If Not Transfemoral, We Should Consider Transcaval Access
Transcatheter aortic valve replacement (TAVR) through transfemoral access has already proven its great benefits, but this access cannot be used in certain patients, and alternative accesses need to be considered for such cases. One of the most commonly used accesses is the transaxillary or transubclavian access (AX), which, however, is associated with more complications (especially…
EuroPCR 2022 | The MITRA TUNE Registry
Left atrial enlargement with or without atrial fibrillation (AF), absence of valvular degeneration, and heart failure with preserved function have recently been identified as functional atrial mitral regurgitation (MR). This subtype of secondary MR currently appears to be underdiagnosed, and the need for treatment in the general population might be greater than predicted. The aim…
EuroPCR 2022 | Real World Outcomes on Edge-to-Edge Tricuspid Valve Repair: 30 Day Outcomes of the TriClip bRight
This study was carried out to assess the safety and efficacy of the TriClip (edge-to-edge repair) in patients with severe tricuspid regurgitation with persistent symptoms despite medical treatment and high surgical risk. It is a prospective multicenter single arm study including 300 patients of mean age 78±7.6; 7.7% presented prior aortic intervention and 28% prior…
EuroPCR 2022 | Should Revascularization Be Performed Before TAVR in Patients with Stable Coronary Disease?
Currently, the American and European guidelines recommend coronary angioplasty in patients with severe aortic stenosis with lesions >70% (Class IIa) who will undergo transcatheter aortic valve replacement (TAVR). However, the benefit of performing a revascularization in these patients is still uncertain. This prospective multicenter study included 2025 patients divided into two groups: complete revascularization (N = 1310)…
EuroPCR 2022 | LYTEN Trial: V-in-V in Small Annuli
TAVR is a valid alternative to treat failed surgical bioprosthetic valves, but one of its biggest challenges is patients with a small annulus. When using self-expanding valves, supra-annular implantation is recommended. However, at present, we only have retrospective, observational studies, not large enough. The LYTEN Trial is a randomized study in patients presenting failed bioprosthetic…
EuroPCR 2022 | Galileo Trial: Mortality Predictors after Successful TAVR
Patients undergoing TAVR are mostly older and more fragile, with comorbidities both cardiovascular and non-cardiovascular. Therefore, they are associated with thromboembolic and bleeding risk. This study looked mortality predictors after successful TAVR in the Galileo trial. Mortality at 248 days was 9.2%, 5.5% being of cardiovascular cause and 3.9% non-cardiovascular. Mortality predictors were age >85,…
EuroPCR 2022 | ASTRO TAVR: Should we treat post TAVR Strokes with Neurointervention?
The presence of stroke after TAVR has dropped and is currently at 2%; however, it is 5 times more deadly, has negatively affected quality of life and has increased healthcare costs. The ASTRO TAVI registry included 14 centers and 16615 TAVR procedures between 2006 y 2021. In this period, there were 484 neurological events within…
EuroPCR 2022 | Changes in Cardiac Damage after Surgical Aortic Valve Replacement
This study presented at EuroPCR 2022 analyzed the PARTNER study pool and included 1974 patients with a complete echocardiogram. Surgical risk was 17.3% extreme/inoperable, 54.3% intermediate and 28.4% low. 60% received transcatheter aortic valve replacement (TAVR) and the rest surgical aortic valve replacement (SAVR). 6.1% of patients were in stage 0 (no damage), 14.5% were…